The effects found in both mines indicate that the mixed exposure can cause lung function disorders in salt miners exposed over a long time. Because of the high correlation of the concentrations it was not possible to determine the effects of a single exposure component separately or to recommend a specific occupational exposure limit. However, possible maximum effects associated with the mixed exposure can be evaluated in the ranges of concentrations of the individual substances in the mines.
Significant differences between non-smokers and active smokers were found for most of the leukocyte types (e.g. granulocytes P = 0.000, lymphocytes P = 0.002, T-cells P = 0.033) and for some soluble parameters (ICAM P = 0.000, IgM P = 0.007, IgE P = 0.035). Increasing numbers of total lymphocytes, T-cells and HLA-DR positive T-cells in relation to exposure were found by linear regression analysis (e.g. for inhalable dust:total lymphocytes P = 0.011, T-cells P = 0.061, HLA-DR positive T-cells P = 0.007). CONCLUSION. Comparison of immunological markers in non-smokers and active smokers confirms leukocytosis and inflammation following tobacco consumption. The combined exposure of salt dust, diesel exhaust and NOx seems to influence the immune system. Together, the results suggest that the analysis of leukocytes and their subsets can complete other investigations (lung function, questionnaire) to monitor exposure-response relationships in occupational studies investigating the effect of inhaled substances. Longitudinal studies will be necessary to determine the predictive value of the immunological changes.
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